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General NPI Number Information
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NPI Number | 1841770278
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Entity Type | Individual
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Provider Name | REBECCA A FERGUSON DPT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | BUILDING 17 BISHOP POINT
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City | PEARL HARBOR
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State | HI
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Zip | 96860
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Country | US
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Telephone | 808-208-1054
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Fax |
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Provider Business Mailing Address
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Address Line | 161 ULUPA ST
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City | KAILUA
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State | HI
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Zip | 96734-2355
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Country | US
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Telephone | 703-946-3665
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2305212242
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305212242
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License Number State | VA
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